Poster abstracts
Poster number 9 submitted by Christopher Vadala
Does spinal cord injury (SCI) impair pressure ulcer (PU) healing? A pilot study
Christopher P. Vadala (Neuroscience Graduate Program), Stephen Vidman, Angela R. Filous (Department of Neurology, The Ohio State University, Wexner Medical Center, Columbus, OH), Jan M. Schwab (Department of Neurology, The Ohio State University, Wexner Medical Center, Columbus, OH)
Abstract:
Background: SCI disrupts the communication between the central nervous and immune system and results in systemic immune dysregulation, which may contribute to the body’s inability to resolve inflammatory events. Resolution of inflammation is an active process that initiates the removal of inflammatory cells (efferocytosis) from the injury site and is required for effective wound healing. A prevalent complication following SCI are PUs, affecting about one in three patients. These highly preventable skin wounds arise from ischemic pressure and shear forces, and some can persist long-term. This leads to re-hospitalization and can be origins for disease and consecutive septic conversions.
Hypothesis: SCI directly blunts PU healing through a dysregulated immune response, resulting in skewed wound healing.
Methods: The direct effects of SCI on PU healing and immune responses will be assessed using a clinically relevant SCI PU mouse model (contusion, 75 kDyne) we have established. This model uses three 24-hour ischemia/reperfusion (I/R) cycles (12h ischemia x 12h reperfusion) using magnets (1012G) applied to the dorsal skin. This creates two distinct skin lesions, with induction beginning three days after SCI. Wound healing and inflammatory responses are assessed using histology and FACS analysis of the PU up to 42 days post-SCI.
Results: Histology demonstrated that the inflammatory response at the PU site is skewed, and wound healing is delayed in animals with SCI compared to sham. We determined and compared differences in epidermis and dermis thickness.
Conclusions: Our data shows that the SCI interferes with wound healing, applying an experimental, controlled PU model. Future experiments will analyze a disruption to resolution in PU and investigate chronic PU development and potential therapeutics to stimulate resolution. The results of these studies can be translated to clinical settings and will advance our understanding of wound healing mechanisms under SCI.
References:
WHO. Spinal cord injury. Published November 19, 2013. Accessed April 5, 2022. https://www.who.int/news-room/fact-sheets/detail/spinal-cord-injury
Prüss H, Kopp MA, Brommer B, et al. Non-Resolving Aspects of Acute Inflammation after Spinal Cord Injury (SCI): Indices and Resolution Plateau: Non-Resolving Inflammation. Brain Pathology. 2011;21(6):652-660.
Bannenberg GL, Chiang N, Ariel A, et al. Molecular Circuits of Resolution: Formation and Actions of Resolvins and Protectins. The Journal of Immunology. 2005;174(7):4345-4355.
Kumar S, Yarmush ML, Dash BC, Hsia HC, Berthiaume F. Impact of Complete Spinal Cord Injury on Healing of Skin Ulcers in Mouse Models. Journal of Neurotrauma. 2018;35(6):815-824.
Peirce SM, Skalak TC, Rodeheaver GT. Ischemia-reperfusion injury in chronic pressure ulcer formation: A skin model in the rat. Wound Repair and Regeneration. 2008;8(1):68-76.
Keywords: spinal cord injury, wound healing, pressure ulcer